Evidence map›Paper›PMID 40685236›Full record

ArticleBMJ open2025

Diabetes and cognitive health in India: a nationally representative survey of adults aged 45 years and older.

David Flood, Hunter Green, Alden Gross, Lindsay C Kobayashi, Deborah A Levine, Jinkook Lee, Caroline R Wixom, Kenneth M Langa

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. The landscape of dementia in India: Prevalence, risk factors, and opportunities ahead.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

David FloodDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA dcflood@umich.edu.ORCID 0000-0002-4372-7387
Hunter GreenCenter for Economic and Social Research, University of Southern California, Los Angeles, California, USA.ORCID 0000-0002-7787-7420
Alden GrossDepartment of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID 0000-0002-4678-0562
Lindsay C KobayashiDepartment of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0003-2725-3107
Deborah A LevineDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Jinkook LeeCenter for Economic and Social Research, University of Southern California, Los Angeles, California, USA.
Caroline R WixomDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Kenneth M LangaDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Funding

Integrting Information About Aging SurveysR01AG030153 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Sara Adar, Alden L. Gross · 2007 to 2026
$41.7M
Research Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Lona Mody, RAYMOND L YUNG · 2004 to 2026
$29.2M
Leveraging a natural experiment to estimate the causal impact of blood sugar on dementia and cognition in IndiaR01AG051125 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Jinkook Lee · 2015 to 2026
$26.8M
Research BaseP30DK092926 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARY ELLEN MICHELE HEISLER, ADESUWA B OLOMU · 2011 to 2026
$10.0M
The Longitudinal Aging Study in IndiaR01AG042778 · NIA · HARVARD SCHOOL OF PUBLIC HEALTH · PI AROKIASAMY, PERIANAYAGAM, BLOOM, DAVID E · 2013 to 2019
$9.0M
Modifiable Protective and Risk Factors of Late-Life Cognitive Health and DementiaRF1AG055273 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI LANGA, KENNETH M, LEE, JINKOOK · 2017 to 2017
$4.0M
Implementation research for comprehensive cardiometabolic care in GuatemalaK23HL161271 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI David Clifford Flood · 2022 to 2026
$949k
NHLBI NIH HHS K23 HL161271NIA NIH HHS P30 AG024824NIA NIH HHS R01 AG030153NIA NIH HHS R01 AG042778NIA NIH HHS R01 AG051125NIA NIH HHS RF1 AG055273NIDDK NIH HHS P30 DK092926
6 · The paper itself

Abstract

objectivesMost research on the relationship between diabetes and cognitive health has used data from high-income countries. This study described this relationship in India, the world's most populous country.

designCross-sectional analysis of the baseline wave of the nationally representative Longitudinal Ageing Study in India, conducted from 2017 to 2019.

settingAll 36 Indian states and union territories.

participants57 905 adults aged 45 years or older.

main outcome measuresScaled cognitive scores (mean of 0 and SD of 1) and cognitive impairment defined as a cognitive score 1.5 SD or below the age-matched and education-matched mean. Diabetes was defined as a self-report of a prior diabetes diagnosis made by a health professional or having a measured haemoglobin A1c ≥6.5%.

resultsIn age-adjusted and sex-adjusted models, people with diabetes had cognitive scores that were 0.24 SD higher (95% CI 0.22 to 0.26) and had a 1.2% (95% CI 0.6% to 1.7%) lower prevalence of cognitive impairment than people without diabetes. Differences persisted even when adjusting for demographic, socioeconomic and geographical characteristics. Rural versus urban residence modified the relationships of diabetes with cognitive score (p=0.001) and cognitive impairment (p=0.003). In fully adjusted models, rural respondents with diabetes had 0.05 SD (95% CI 0.03 to 0.07) greater cognitive scores and 1.6% (95% CI 0.9% to 2.4%) lower prevalence of cognitive impairment than those without diabetes. In urban areas, respondents with and without diabetes had similar cognitive scores and prevalence of cognitive impairment.

conclusionsMiddle-aged and older adults with diabetes living in India had better cognitive health than those without diabetes. Rural versus urban area of residence modified this relationship. Urban-rural differences, the nutrition transition and social conditions likely influenced the cross-sectional relationship between diabetes and cognitive health in India, leading to different associations than reported in other countries.

Indexed as

CognitionCognitive DysfunctionDiabetes MellitusAgedCross-Sectional StudiesFemaleHumansIndiaLongitudinal StudiesMaleMiddle AgedPrevalenceRural PopulationUrban Populationdelirium & cognitive disordersgeneral diabetesgeneral medicine (see internal medicine)

Identifiers

PMID40685236
PMCPMC12278164

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.